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ARTICLE |

Ethacrynic Acid in Pathological Fluid Retention FREE

Robert J. Sperber, MD; Leonard B. Di Re, MD; Mark M. Singer, MD; Solomon Fisch, MD, PhD; Arthur C. DeGraff, MD
[+] Author Affiliations

Reprint requests to 130 W Kingsbridge Rd, New York 10468 (Dr. Sperber).


From the Cardiac Therapy Research Unit, Medical Service, VA Hospital (Drs. Sperber, Di Re, Singer, and Fisch), and New York University School of Medicine (Dr. DeGraff), New York.


JAMA. 1965;191(9):703-706. doi:10.1001/jama.1965.03080090017004
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Ethacrynic acid was effective in completely reversing pathological fluid retention in 13 of the 14 patients studied. The long-term studies in 29 patients demonstrated the effectiveness and relative safety of the drug when used in cases of true diuretic need over a period of months. The dose had to be individualized, but was generally 50 mg twice daily in digitalized patients. When used in higher doses or in combination with other effective diuretics, the marked fluid loss occasionally resulted in serious changes in electrolyte balance. Therefore, caution is necessary when introducing this new and useful oral diuretic in instances in which it is truly needed for effective management of pathological fluid retention.

REFERENCES

Schultz, E.M., et al:  α-β-Unsaturated Ketone Derivatives of Aryloxacetic Acids, New Class of Diuretics , J Med Pharm Chem 5:660-662 ( (May 25) ) 1962;.
Foltz, E.L.:  Preliminary Clinical Observations With an Aryloxyacetic Acid Diuretic , Fed Proc 22:598 ( (March) -April, pt 1) 1963;.
Maher, J.P., et al:  Effect of Ethacrynic Acid on Refractory Edema , abstracted, Clin Res 12:70 ( (Jan) ) 1964;.
Fisch, S., et al:  Sodium Tolerance of Digitalized Cardiacs as Method of Evaluating Diuretics and as Guide to Diuretic Therapy , read before the 62nd annual meeting of the American Therapeutic Society, New York, June, 1961 .
Baer, J.E., et al:  New Class of Diuretic-Saluretic Agents, α-β-Unsaturated Ketone Derivatives of Aryloxyacetic Acids , Pharmacologist 4:158 ( (Fall) ) 1962;.
Baer, J.E.:  2,3-Dichloro-4-(2-Methylenebutyryl)-Phenoxyacetic Acid (1), Novel and Potent Diuretic-Saluretic Agent , Fed Proc 22:598 ( (March) -April, pt 1) 1963;.
Melvin, K.E.W.; Farelly, R.O.; and North, J.D.K.:  Ethacrynic Acid: New Oral Diuretic , Brit Med J 1:1521-1524, 1963;.
Daley, D., and Evans, B.:  Diuretic Action of Ethacrynic Acid in Congestive Heart Failure , Brit Med J 2:1169-1171 ( (Nov 9) ) 1963;.
Brest, A.N., et al:  MK 595: Diuretic Assay and Renal Functional Response , Circulation 28:694 ( (Oct) , pt 1) 1963;.
Cannon, P.J.; Ames, R.P.; and Laragh, J.H.:  Methylenebutyryl Phenoxyacetic Acid , JAMA 185:854-862 ( (Sept 14) ) 1963;.
Goldberg, M., et al:  Effects of Ethacrynic Acid (New Saluretic Agent) on Renal Diluting and Concentrating Mechanisms: Evidence for Site of Action in Loops of Henle , J Clin Invest 43: 201-216 ( (Feb) ) 1964;.
Dollery, C.T.; Parry, E.H.O.; and Young, D.S.:  Diuretic and Hypotensive Properties of Ethacrynic Acid: Comparison With Hydrochlorothiazide , Lancet 1:947-952 ( (May 2) ) 1964;.
Ledingham, J.G.G.:  Ethacrynic Acid Parenterally in Treatment and Prevention of Pulmonary Edema , Lancet 1:952-954 ( (May 2) ) 1964;.
Komorn, R.M., and Gafruny, E.J.:  Ethacrynic Acid: Diuretic Property Coupled to Reaction With Sulfhydryl Groups of Renal Cells , Science 143:133-134 ( (Jan 10) ) 1964;.

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Schultz, E.M., et al:  α-β-Unsaturated Ketone Derivatives of Aryloxacetic Acids, New Class of Diuretics , J Med Pharm Chem 5:660-662 ( (May 25) ) 1962;.
Foltz, E.L.:  Preliminary Clinical Observations With an Aryloxyacetic Acid Diuretic , Fed Proc 22:598 ( (March) -April, pt 1) 1963;.
Maher, J.P., et al:  Effect of Ethacrynic Acid on Refractory Edema , abstracted, Clin Res 12:70 ( (Jan) ) 1964;.
Fisch, S., et al:  Sodium Tolerance of Digitalized Cardiacs as Method of Evaluating Diuretics and as Guide to Diuretic Therapy , read before the 62nd annual meeting of the American Therapeutic Society, New York, June, 1961 .
Baer, J.E., et al:  New Class of Diuretic-Saluretic Agents, α-β-Unsaturated Ketone Derivatives of Aryloxyacetic Acids , Pharmacologist 4:158 ( (Fall) ) 1962;.
Baer, J.E.:  2,3-Dichloro-4-(2-Methylenebutyryl)-Phenoxyacetic Acid (1), Novel and Potent Diuretic-Saluretic Agent , Fed Proc 22:598 ( (March) -April, pt 1) 1963;.
Melvin, K.E.W.; Farelly, R.O.; and North, J.D.K.:  Ethacrynic Acid: New Oral Diuretic , Brit Med J 1:1521-1524, 1963;.
Daley, D., and Evans, B.:  Diuretic Action of Ethacrynic Acid in Congestive Heart Failure , Brit Med J 2:1169-1171 ( (Nov 9) ) 1963;.
Brest, A.N., et al:  MK 595: Diuretic Assay and Renal Functional Response , Circulation 28:694 ( (Oct) , pt 1) 1963;.
Cannon, P.J.; Ames, R.P.; and Laragh, J.H.:  Methylenebutyryl Phenoxyacetic Acid , JAMA 185:854-862 ( (Sept 14) ) 1963;.
Goldberg, M., et al:  Effects of Ethacrynic Acid (New Saluretic Agent) on Renal Diluting and Concentrating Mechanisms: Evidence for Site of Action in Loops of Henle , J Clin Invest 43: 201-216 ( (Feb) ) 1964;.
Dollery, C.T.; Parry, E.H.O.; and Young, D.S.:  Diuretic and Hypotensive Properties of Ethacrynic Acid: Comparison With Hydrochlorothiazide , Lancet 1:947-952 ( (May 2) ) 1964;.
Ledingham, J.G.G.:  Ethacrynic Acid Parenterally in Treatment and Prevention of Pulmonary Edema , Lancet 1:952-954 ( (May 2) ) 1964;.
Komorn, R.M., and Gafruny, E.J.:  Ethacrynic Acid: Diuretic Property Coupled to Reaction With Sulfhydryl Groups of Renal Cells , Science 143:133-134 ( (Jan 10) ) 1964;.
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